Nicola Piroth: a creative approach to psychotherapy in Grenoble
June 16th, 2010 | Published in Features, Interviews, Work & Study
Nicola Piroth at work and at play
Nicola Piroth is a play therapist with a private practice in Grenoble. She talks to Grenoble Life about creative approaches to psychotherapy, her international background and setting up a cabinet in France.
Grenoble Life: Tell us a little about your methodology.
Nicola Piroth: I practise as a play therapist, which means that I use a creative approach to psychotherapy. Play therapy recognises that children naturally use play as a creative form of self-expression and communication in order to grow and develop, as well as to address traumatic and painful issues from a safe distance. Children that are faced with distressing life events may not feel comfortable talking about their emotions, but through play therapy they can communicate and explore their feelings, learn skills and tools to heal their emotional pain.
In my cabinet, I mostly see children and adolescents in individual, regular play therapy sessions. However, I also use another approach called filial therapy with some families. Using this alternative method I train parents to conduct individual play sessions – similar to play therapy but with their own children. This way of working can be so helpful when communication hasn’t been possible between parents and their children – for any number of reasons, but often simply because we don’t get any training to be parents even though it is quite possibly one of the hardest tasks we are faced with as adults. Children communicate through play – it is their innate language. By teaching parents the language of play, and how to use play therapeutically, the communication gap between parent and child can be closed.
Perhaps it is surprising, but I also use play therapy, and more specifically sandplay therapy, with adults. Using small trays of sand, clients sculpt the sand and position miniature objects and figurines to create scenes, worlds or designs that are expressions of their inner world. Sandplay therapy gives the client direct access to their internal self, allowing them to understand issues in a deeper way. As adults we often get stuck in certain situations or circular ways of thinking, and it is helpful to use a creative non-verbal tool to explore our inner workings, alongside more traditional dialogue.
GL: Does this methodology differ to established methods in France?
Nicola: As far as I know, traditionally, psychotherapy here has mostly been a verbal, intellectual process, perhaps based on a more medical model of psychiatry concerned with cause and effect. This relies mostly on talking things through. In play therapy we additionally use non-verbal, creative approaches that give space to the intuitive Self – the part of us that knows what it needs to heal, even if it can’t explain it. Experiencing our Self at this level allows us to integrate what we feel and what we know intellectually in order to move on.
Another aspect of the predominant model of psychotherapy in France is that it is still largely ‘adult’ led, with the doctor, psychiatrist or therapist seen as knowing more than the patient who is a passive recipient of the treatment. In my own work, I believe it is essential to follow the client’s lead, to trust that – given a safe and accepting environment (as in child-centred play therapy) – children have within them the desire and strength to find their own way to heal and to grow.
This non-directive approach facilitates the development of self-responsibility, self-control, and appropriate self-esteem. It is my responsibility as the therapist to provide that safe and containing space in which the child can explore who they are, how they feel and ‘play out’ different solutions. This also has larger implications regarding how I work with parents. I believe therapy must be a collaborative effort. For the child to have the safe space in my office is one thing, but regular meetings between the parents and I give parents the support they need in order to be able to accompany their child on the journey towards growth and change.
GL: Who comes to you and what are some of the reasons why?
Nicola: I see clients between one and 100 years of age … Traditionally play therapy was developed to work with the specific needs of 2–12 year olds, but I practise a more general creative psychotherapy that I feel applies to all of us…
Why do people seek psychotherapy for themselves or for their children? It’s a very big question that has as many answers as there are people in therapy… adults come to work on existential issues, difficult life experiences (such as divorce, a loss, or adapting to a new country), or to further their personal development. Children and adolescents are referred for equally diverse reasons, for example, their parents have noticed low self-esteem, depression, or the development of challenging behaviours at home or at school. Perhaps the family or child has recently undergone a traumatic experience – ranging from maltreatment to moving homes, the birth of a sibling, long-term illness and hospitalisation, adoption, bullying … to name but a few.
Yet other children have difficulties ‘fitting in’ (whatever that means!), struggle at school, or have been diagnosed with developmental difficulties that require a little extra help to develop their sometimes hidden potential. Play therapy is useful for a whole range of emotionally-based problems of behaviour and adjustment.
GL: Are these reasons different in any way to those you have encountered working in other countries?
Nicola: Regarding my work with children, I would say that generally the reasons are the same here – parents come because they are worried about their children – and though the way I work using play is unknown in France, it attracts a lot of people looking for a more child-centred approach. International families often come to the cabinet when they feel misunderstood or judged by more traditional French therapists who might be unfamiliar with different child rearing and cultural practises (for example long-term breastfeeding or co-sleeping), or the challenges facing multi-cultural families.
I certainly do not pretend to understand the cultural background of all of the families I work with, but through my own personal experience, I am aware of some of the daily struggles one faces just trying to adapt to something as potentially stressful as a new school system …
GL: Where do you come from and where did you train as a therapist?
Nicola: That’s not such an easy question for me to answer… I was born in Germany to German parents, and have since lived in six different countries across four continents. I originally trained as a psychologist specialising in child development in the UK, but after a short career in a major child and adolescent psychiatry unit in London conducting psychological research I decided to train as a play therapist.
I think I realised that I am much better suited at playing Peter Pan with four year olds than at establishing a diagnosis or quantifying human experience in order to plug the results into a computer for analysis. Don’t get me wrong, I respect and value psychometric testing when it’s necessary and well-carried out by a sensitive psychologist – but those are not my skills and no longer the approach I practise. My training as a psychologist remains extremely useful to me and it definitely informs my work, but I have tried to move away from ‘putting problems in boxes’ to working and thinking problems ‘out of the box’.
GL: What languages do you work in and why?
Nicola: I work using the languages I am fluent in – that is English, German and French.
GL: Why did you come to Grenoble?
Nicola: Our move from the USA to Grenoble was not an easy one for me – I loved living in California, but at that time it was necessary for our family to return to Europe. Luckily we were able to settle in Grenoble since it’s so central in this fantastic mix that is Europe.
GL: What difficulties, if any, did you have in setting up your cabinet in Grenoble?
Nicola: Perhaps the biggest hurdle for me was that play therapy didn’t exist here – at all. There wasn’t even a French translation for it, so I made up my own, la Thérapie par le Jeu. I am affiliated and registered with several international play therapy associations – but none of my foreign qualifications were recognised in France. Coupled with an attitude I frequently encounter here of “no one’s every done that before, so surely there is no point changing things by trying something new now….” I took a risk setting up my practise without any professional network. And now, of course, that the cabinet is up and running, the French reaction is extremely positive and open minded with reactions such as “why don’t you train people here”!
GL: What advice would you give people setting up their own businesses/private practices in France?
Nicola: I’m not sure about giving advice, other than don’t be put off by all the scary looking forms and impressive civil servants. It does sometimes feel like everyone is trying to dissuade you from even trying, either by piling useless and endless paperwork at you or by sounding generally negative and complicated about relatively straightforward business. But if you have enough time to stand in queues and patiently rephrase your question for the third time, often that very same administration (like the URSSAF) can actually be a goldmine of information. France really is ready for some innovative business ideas, if you can just navigate and bully your way through the system.
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